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Vendor Forms

During this transition to the new SPIRIT management information system, the Alaska WIC Program will not accept new applications for authorization as a WIC vendor. An information packet for interested retail food stores will be posted on the WIC website on or before February 1, 2014. Thank you for your patience during this transition.

Download Vendor Forms.
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Instructions for submitting minimum stock

Key Bank Request Form for WIC Warrant Electronic Reimbursement Payment

WIC Check Appeal Request form

The form to be used when requesting reimbursement payment from the State of Alaska through KeyBank

Vendor Supplies Form
Supplies orderform between vendor and State of Alaska.

Retraining Form (4/10)
This form may be used by vendors to notify us of a problem experienced with a client who does not seem to understand the WIC program rules or how to purchase the correct foods. It can also be used by a client to help us identify cashiers that may need additional training on WIC policies and procedures.

Alaska WIC Program Complaint Form
Form to fill out in case of complaint.

WIC Food Exemption Request Form